提昇急診留觀區護理人員交班完整性之改善專案

A Project to Improve Nursing Hand-off Reports in the Emergency Department

急診為病患人潮擁擠且醫療處置繁雜的工作場域，因應病息治療需求分為檢傷、留觀、急救等區段照護病患；護理人員在不同區段的照護業務能正確且完整的交班成為病患安全的必要項目之一。本院急診留觀區護理人員40名，僅5名(12.5%)能100%完整且正確交班，十大交班項目平均完整率為62.0%，因此成立專案小組探討影響因素、進行改善。藉由建立內部與跨科間交班規範、增設交班輔助紀錄單、辦理共識會議及在職教育，搭配品管稽核業務等改善措施，將護理交班完整率提昇至92.5%。透過本專案實施成效與經驗之分享能提供其他醫療機構急診單位護理相關業務改善之參考。

Emergency departments (EDs) are places crowded with patients receiving complex medical treatments. Based on the patients' conditions and needs for treatments, ED is divided into three areas: triage area, observation area, and resuscitation area. Accurate and complete nursing hand-off reports comprise one of the required duties related to patient safety This project aims to investigate affecting factors that cause the low completion of hand-off reports and plans for improvement. 40 nurses worked in the ED of the hospital. Five nurses performed accurate and complete hand-off reports (12.5%). A properly completed nursing hand-off report involved finishing a total often hand-off items. 62% of nurses completed such a report. Improvement measusres included a hand-off report model in the department and with other departments, a hand-off recording format, meetings for consensus and in-service, and quality audits. The rate of correctly completed nursing hand-off reports raised from 62% to 92.5%. This project may be used as a reference for other EDs toward improving performance in nursing hand-off reports.